A 33-year-old woman from Beit El who underwent a heart transplant five years ago gave birth to premature but healthy twin girls yesterday. She is the first heart transplant recipient to give birth in Israel and the fifth around the world to deliver twins.

Approximately 70 women around the world have had children after receiving a new heart.

The babies were conceived through in vitro fertilization and delivered by Caesarean section at Jerusalem's Hadassah University Hospital, Mount Scopus. The hospital released a statement saying the mother and babies are doing well.

One of the babies weighed 1.5 kilograms at birth and the other weighed 2 kilograms. They were born seven weeks early.

The birth demonstrated to Israeli doctors that women can indeed become mothers after receiving a new heart, even though in most cases pregnancy ends in miscarriage, said Prof. Yaacov Lavee, a surgeon at Sheba Medical Center, Tel Hashomer. Lavee carried out the woman's heart transplant in 2005.

"We generally don't encourage pregnancy after heart transplants, but in this case the husband and wife really wanted to bring children into the world, and it was a will that could not be withstood," he said. "The message we received from the birth is that a heart transplant is not the end, but the beginning of a very hopeful time."

Lavee said that drugs used to prevent a patient's body from rejecting a transplant lead to increased risks for pregnancy and birth. But, he said, "with close supervision, it turns out that this kind of pregnancy is possible."

"During pregnancy, it's necessary to meticulously balance the medications that prevent transplant rejection - which are liable to harm the fetus - and replace them with other drugs in appropriate doses so as not to damage the transplanted heart on the one hand or the fetus on the other," said Lavee.

In addition to contending with transplant drugs, women who have undergone heart transplants also face the increased burden on the heart that comes with any pregnancy.

"There are hormonal changes during pregnancy and a cessation of fluids that are liable to put a load on the heart," said Dr. David Zechut of the obstetrics and gynecology department at Hadassah Mt. Scopus, who monitored the woman's pregnancy. Pregnant women who are not transplant patients carry the added load relatively easily, he said, "but with a transplant recipient, this could cause heart complications."

The new mother has been in and out of the hospital since she was a year old, when a growth was discovered on her kidney. She underwent surgery and chemotherapy, and by the time she was 9 the drugs she was taking began causing her heart problems.

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